HOSPITAL LEVIES

Evening Star, Issue 20061, 29 December 1928, Page 6

HOSPITAL LEVIES

HEALTH DEPARTMENT'S ANALYSIS [SVECIA.L 10 THE ' STAft.’J WELLINGTON, December 29. Arguments advanced by the local bodies for an alteration in the incidence of hospital levies are, according to the Health Department, a twoedged sword and may equally w’dl be used in support of tho present system. This view is put forth by tho department in the course of a survey of the year just ended. “ Representation of contributory local authorities or, hospital boards is at present on a fifty-fifty basis—a mean between population and valuation,” says the departmental statement. ‘[Levies by the boar Is on the local bodies are on a valuation basis only, and it has been urged by representatives of the country interests that levies should also be on a fifty-fifty basis, it being argued that it is the population that uses the hospitals and that it is the population which should bear a greater part of tho levies than at present. “ If it bo admitted that taxation and representation should be on tho same basis, then this does not at first sight appear to be an illogical suggestion (provided, of course, that the existing method of representation is equitable, and it at least possesses the merit of an accepted compromise). Apart from general economic arguments showing that towm and country interests are intenvoven and interdependent, it is obvious that a densely populated contributory district must send more patients to the hospital and receive more charitable aid than m a more sparsely populated district, no matter in what part of the hospital district such density of population occurs. Except In the very remote localities, which daily are becoming less remote owing to the improvement in roads and motor service, it is the density of population rat hoi than the nearness to the hospital that affects the number of in-pa-tients. It is true that nearby residents enjoy to a much greater extent the privilege of the out-patients’ department which, however, at present does not form any considerable part of the expense “ Unfortunately, however, this appears to be all that can be said in favour of the proposal, which appears to possess grave inherent defects. The above, indeed, may he used as an argument in favour of the present incidence ot levies, as showing the availability of a hospital to all residents of its district The somewhat vague statement that it is townspeople that use the hospital and that they therefore should contribute more to fhe deficit does mot fully or fairly convey the correct conclusion. It may he the case that the townspeople are the greater users of the hospital, in so far as the greater number of poor people unable to pay their fees are found where the population is densest. It is acknowledged that those who use the hospital should pay as much as they are able, tiie cost of treatment, in fact, being a debt due and recoverable by the boards from those able to meet it. As regards the residual cost, however, it is not a question ot the use of the hospital, but of the availability of the hospital that should govern its apportionment. Otherwise only those that use the hospital should bo rated for the hospital. Why should a man who lives in a poor neighbourhood with a congested population pay a higher rate on his property for hospital service than another who lives in a less crowded and more prosperous part of the district? Moreover, the facts themselves tend to discount the value of the suggestion. In Wellington, where, roughly one-twelfth of both the population and the valuation arc in the counties, the fifty-fifty proposal would have little effect either on the town or the country. and would scarcely be worth the involved calculations necessary to apportion the levy. In Ashburton the proposal might operate harshly. The Ashburton hospital district contains a county population of 12,450, with a valuation ot its borough and town district contains a population of 5(865, and a valuation of £788,000. 'At present its levy for maintenance purposes is O.lofid on both county and town, the county finding £7,547. and the borough and town £516. Under a fifty-fifty system, the county would find £6,515, or 0.135 din the pound, and the town £1,548, or 0.47R1 in the pound. The town contribution, in fact, w’ouid be trebled. At present the county pays about fifteen times as much as tho borough, under the 'proposed arrangement it would pay four and a-half times as much. “ Yet in 1927-8, of the 810 patients admitted to the Ashburton Hospital, 528 came from the country and 282 from the borough and town district. It cannot, therefore, bo argued that this hospital is used to an undue extent by the town at the expense of the country in very close proportion. Moreover, the relation of population to valuation is very diverse - throughout the hospital districts of the. dominion.”